October 1, 2013

Insurance markets open to surge of new customers

A combination of high demand and technical glitches seemed to overwhelm the online system early in the day.

By CARLA JOHNSON
The Associated Press

(Continued from page 1)

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In this Wednesday, Sept. 25, 2013, photo, Maygan Rollins, 22, a field organizer with Enroll America, holds a clipboard with pamphlets while canvassing at a bus stop in Miami. Enroll America is a private, nonprofit organization running a grassroots campaign to encourage people to sign up for health care offered by the Affordable Care Act.

The Associated Press

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Lielasus, a 54-year-old self-employed grant writer, currently spends about $8,500 a year in premiums and more than $10,000 for out-of-pocket expenses because she has a health condition and her only option has been a state high-risk insurance pool. She said she expects those costs to decrease significantly.

As excited as she was to sign up, she said, her anticipation was tempered by dismay over the government shutdown that was led by congressional Republicans who want to block the health insurance reforms.

“I’m really happy that this is happening, that this is being launched ... I feel like it’s a child caught in the middle of a really bad divorce,” Lielasus said.

The shutdown will have no immediate effect on the insurance marketplaces that are the backbone of the law, because they operate with money that isn’t subject to the annual budget wrangling in Washington.

The marketplaces represent a turning point in the nation’s approach to health care. The Obama administration hopes to sign up 7 million people during the first year and aims to eventually sign up at least half of the nearly 50 million uninsured Americans through an expansion of Medicaid or government-subsidized plans.

But if people become frustrated with the malfunctions in the computer-based enrollment process and turn away from the program, the prospects for Obama’s signature domestic-policy achievement could dim.

“You’ve got to launch this thing right the first time,” said Robert Laszewski, a consultant who worked 20 years in the insurance industry. “If you don’t, financially you will never recover.”

Neera Tanden, president of the Center for American Progress, which helped work for passage of the law, cautioned against rushing to judge on first-day performance. Numerous observers had predicted bugs and setbacks. Trained outreach workers in many states are having trouble getting the certification they need to start helping people to enroll.

In Texas, a federally funded network of “navigators” hired to help people enroll was off to a rocky start because of backtracking participants — including some cowed by the politics of the health law.

At least four regional government councils — covering more than 30 counties statewide — reversed course in the past two weeks and turned away funds that would train navigators in their areas. Local leaders described their hesitancy as a mix of uncertainty surrounding state rules and a fear of running afoul of Republican leaders.

Many states predicted that an initial surge of interest would test the online system, but they expect most people to sign up closer to Dec. 15, which is the deadline for coverage to start Jan. 1. Customers have until the end of March to sign up in order to avoid tax penalties.

Under the law, health insurance companies can no longer deny coverage to someone with a pre-existing medical condition and cannot impose lifetime caps on coverage. They also must cover a list of essential services, ranging from mental health treatment to maternity care.

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